Predictors of Progressive Rheumatoid Arthritis Identified

NEW YORK (Reuters Health) Jan 14 - US researchers have identified several factors that predict which patients with early rheumatoid arthritis will experience radiographic progression of their disease. Predictors of a poor radiographic outcome include rheumatoid factor (RF) positivity, HLA-DRB1 polymorphisms, older age, and certain immunosenescence markers.

The findings, published in the January issue of Arthritis and Rheumatism, are based on a study of 111 consecutive patients with rheumatoid arthritis of less than 1 years' duration. Ninety-four of the patients completed the 2-year follow-up period.

During the study period, 52% of patients were able to control their disease with hydroxychloroquine and nonsteroidal agents, lead author Dr. Jorg J. Goronzy, from the Mayo Clinic in Rochester, Minnesota, and colleagues note. Forty-eight percent of subjects remained erosion-free during follow-up.

Erosions at baseline were also identified as a predictor of radiographic disease progression, the investigators note. A high frequency of CD4+,CD28- T cells was directly associated with the risk of progression.

Conversely, a polymorphism in the uteroglobin gene seemed to predict a low risk of disease progression, the authors found.

"Our study documents the need to identify prognostic markers in order to make early treatment decisions in rheumatoid arthritis," the researchers state. "New markers, such as the uteroglobin gene, and biologic markers of cellular senescence show promise and warrant further investigation."